Tretman depresije nakon akutne faze poremećaja

Abstract

Introduction: Depression is one of the most prevalent and, in terms of its public health impact, the most significant mental disorders. The effectiveness and safety of the currently available pharmacotherapeutical options most often make it possible to achieve remission in patients, but insufficient attention is paid to the continuation of treatment. The purpose of this review is to remind both psychiatrists and general practitioners about the need to continue treatment after achieving remission in the acute phase of depression, in order to prevent the occurrence of relapse or recurrence of the disorder. Method: The recommendations and conclusions of the most relevant domestic and foreign clinical practice guidelines for the treatment of depression, as well as experimental works that dealt with the aforementioned issues, were discussed and presented. Results: All available literature, as well as clinical practice, indicate the necessity of continuing the treatment of depression for at least 6-9 months after achieving remission in the acute phase of the disorder, with the same type and the same dose of antidepressants in order to avoid an almost certain relapse. After that, it is necessary to take into account risk factors for recurrence, which include: greater number of previous episodes, previous psychotic episodes, the presence of comorbid mental or somatic disorders, psychosocial stressors, all in order to decide the length of the next stage of the treatment, maintenance phase, using therapy that previously led to remission. Conclusion: It is necessary to continuously remind psychiatrists, general practicioners, patients and their families that achieving remissions after an acute episode of depression does not allow treatment discontinuation due to the high degree of recurrence in this disorder.